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Health Total Plan

Health Total - Medical Insurance Plan For Family


Find out how this plan works for you

 

Health Total is a Comprehensive Retail Health Product with wider and long term coverage.

There are 3 different plans: Vital, Superior and Premiere. All plans are available with individual and floater option and with Lifelong renewal facility.

Family definition:

Vital Plan - Self, spouse, dependent children (unmarried and up to the age of 25 years) and dependent parents

Superior Plan & Premiere Plan - Self, spouse, dependent (unmarried and up to the age of 25 years) or non – dependent children, dependent or non – dependent parents, dependent siblings, daughter in law, son in law, parents in law, grandparents and grandchildren (maximum up to 15 members).

 

Sum Insured available in the product are as below:

Policy Term:

Minimum Policy Term 1 Year
Maximum Policy Term 3 Year

Eligibility

Entry Age

Day One up to any age

Maximum Sum Insured

up to Rs 1 Crore

Pre acceptance Medical Tests

Age upto 50 years in Vital plan:
Medical tests not required

Age above 50 years in Vital plan:
Medical tests required

Age From 18 years onwards in Superior plan:
Medical tests required

Age From 18 years onwards in Premiere plan:
Medical tests required

No tests required for children below 18 years for any plan.

** Age in completed yeasured is eligible for 100% of reimbursement of pre-acceptance medical tests charges subject to policy issuance & 64 VB compliance.re policy tests need to be done in the empanelled diagnostic center’s only. test would be valid for a period of one month from the date the tests have been conducted

What’s Covered

  • Expenses covered -

    Hospitalization Medical Expenses, Day Care Treatment expenses, Pre-hospitalization Medical Expenses, Post-hospitalization Medical Expenses, Organ Donor Expenses, Domiciliary Hospitalisation Expenses.

  • Restoration of the Sum Insured -

    If the Sum Insured and Cumulative Bonus (if any) is exhausted due to claims payable, Restore Sum Insured (equal to 100% of the Sum Insured) will be automatically available for the particular Policy Year subject to T & C.

  • Maternity Expenses -

    Maternity benefit with only two years of waiting period when both husband and wife are covered together

  • Miscellaneous Coverages -

    Patient Care, Accompanying Person, Road Ambulance Charges, Wellness Care, E-Opinion in respect of an Illness or Injury and Alternative Treatment

  • Accidental Hospitalization -

    Increase in the Sum Insured by 25% of the available balance Sum Insured subject to maximum 10 lakhs in case of Accidental Hospitalisation.

  • Emergency Medical Evacuation (applicable for Superior Plan and Premiere Plan) -

    We will reimburse expenses under this Benefit incurred for medical evacuation from the place of local Hospitalisation /Accident to any other Hospital within India.

  • Out Patient Medical Expenses -

    (applicable for Superior Plan and Premiere Plan)

  • Reimburse Expenses -

    We shall reimburse expenses towards consultation, diagnostic tests and medications prescribed as per plan opted.

  • Child Vaccination Benefits (applicable for Premiere Plan) -

    We will cover charges for vaccinations for child less than 12 years of age.

  • New Born Baby -

    (applicable for Superior Plan and Premiere Plan)

  • Medical Treatment Abroad for listed conditions -

    (applicable for Premiere Plan)

  • Additional covers -

    Patient care, Accompanying Person, Road Ambulance Charges, E-Opinion in respect of an Illness or Injury, Alternative Treatment, Wellness Care

  • Cumulative Bonus -

    50% for every claims free year to a maximum of 100% * Product coverage’s applicable would be as per plan opted

Other Features

  • Family discount of 10% is available in case more than one person is covered in the same policy in case of Individual Sum Insured option.

  • Floater Discount:

    Premium applicable for the primary insured will be the standard individual premiums. For remaining dependant members, floater discounts will be applicable on their respective premium as per their age.

  • Voluntary deductible discount:

    Discount of 10% to 25% on premium as per the voluntary deductible and plan opted.

  • Long-term discount upto 10% applicable in case of upfront premium payment for long term policy.

  • Instalment Facility:

    In case of policies which are on long term basis, facility of instalment payment is available monthly, quarterly and half yearly. Loadings maximum of 5% will be applicable on standard premiums as per the instalment frequency opted.

  • Loading on Claim experience:

    There will be no loading on premium for adverse claims experience.

  • Tax benefit:

    Premium paid by any mode other than cash is eligible for tax relief as provided under Section 80-D of the Income Tax Act.

  • Copayment Applicability :

    In case an insured enters the policy at age of 60 years and above , copayments will be applicable on each and every admissible claim

Exclusions of this plan

  • External Congenital Anomaly and related Illness/ defect.

  • Expenses incurred towards treatment of Illness or Injury arising out of alcohol use/misuse or abuse of alcohol, narcotic substance or drugs (whether prescribed or not).


    Waiting Periods

    Waiting
    Period
    Diseases
    30 daysAny
    illness,diagnosed or diagnosable except
    those incurred as a result of Injury
    24 months*Pre-
    existing conditions, Internal Congenital, Cataracts, BPH, Hernia, DNS,
    Fistulae, hemorrhoids, Hysterectomy etc.
    48 monthsOrgan
    transplant, Rheumatoid Arthritis, Gout, Joint replacement due to degenerative
    condition ,age related osteoarthritis, Osteoporosis,unless due to injury
    *Pre-existing conditions will be covered up to 50% of the admissible claim amount during the third year and up to 100% from the fourth year of continuous Renewal with Us.

  • Non-prescribed drugs and medical supplies, hormone replacement therapy, sex change or treatment which results from or is in any way related to sex change.

  • Injury or Illness directly or indirectly caused by or arising from or attributable to war, invasion, act of foreign enemy, war like operations (whether war be declared or not)

  • To view the list of Non – Payable items, click here.

How can you buy this Policy?

Please contact our nearest Branch Office














 

What happens next after I have purchased

When you become a Future Generali Health Customer, you will receive a membership pack containing the following:

  • Health card to utilise cashless facility at Network hospitals. You can avail discounts offered by our Allied Partners. Check out our FGH Privilege section for more details.

  • Policy Schedule

  • Premium Receipt

  • 80D certificate for tax deduction if the premium is paid via Credit Card/Debit Card, Net Banking, or Cheque except cash payment.

  • Policy coverage and Terms & Conditions


Making a Claim

At Future Generali, we will do everything to make your claim as simple and convenient. And here are few reasons why:

  • We have an in-house claim settlement team that processes your Cashless claims within 90 minutes from the time we receive your Cashless Request and Reimbursement claims within 10 working days from the time we receive your complete claim documents.

  • In order to get the periodic update on your claim, please ensure to mention your Mobile Number and e-mail Id on the claim form.

  • Find out more about how to make a claim or check out our claim process.

  • In-house team of professionals who can give specialised advice.

Contact our Helpline

In case you wish to speak to our experts about your policy, you can call us on:

1800-220-233

You ask. We answer.

Why choose Health Total?
How do I decide on an appropriate cover amount?
What do you mean by entry age?
What are the entry age limits under Health Total?
Is there an exit age under Health Total?
Whom can I keep as my nominee?
What is the family definition?
Does Health Total cover Senior Citizens?
Is there any tax benefit?
What do you mean by in-patient and out-patient Treatment?
What is Day Care Procedure?
Are all the systems of medicine covered under this insurance plan
What is included in Donor expenses?
What is e-opinion in respect of an illness or Injury.
What do you mean by Restoration benefit?
What is Family floater Health Total policy?
Who will be paying for the pre policy tests?
Will you get discount if you are insuring more than one family member in the same policy?
Is there any provision of enhancing the Sum Insured after taking Health Total?
What is dependent sum insured criteria?
Is there any grace period available to renew the policy when a customer forgets to renew before the expiry date of the expiring policy?
What do we mean by cumulative bonus? How much bonus is offered under Health Total?
What is the sublimit for surgery on cataract?
What are the waiting periods in the policy?
What are the General Exclusions under the policy?
What are the exclusions applicable for OPD treatments
What are Network /Non-network provider?
Where do I contact in case of a claim?
What other assistance is available on call center?
What do terms Cashless Facility and Claim Reimbursement mean?Cashless Facility
What is the time limit to notify the claim?
Where do I need to submit claim documents?
How is premium calculated?
Who will require undergoing pre policy medical examinations?
 

Top reasons why this plan is ideal for you

With Health Total, we can give you a comprehensive cover, a near –perfect answer to all your medical needs.

1

Hospitalisation Medical Expenses

2

Day Care Treatment Expenses

3

Pre-Hospitalisation Medical Expenses

4

Post-Hospitalisation Medical Expenses

5

Restoration of Sum Insured

6

Maternity Expenses

7

Organ Donor Expenses

8

Patient Care

9

Accident Hospitalisation (Increase in Sum Insured)

10

Accompanying Person

11

Road Ambulance Charges

12

Emergency Medical Evacuation (Applicable for Superior and Premiere Plan)

13

Domiciliary Hospitalisation Expenses

14

Out-Patient Medical Expenses (Applicable for Superior Plan and Premiere Plan only)

15

Child Vaccination Benefits (Applicable for Premiere Plan)

16

New Born Baby (Applicable for Superior and Premiere Plan)

17

E-opinion in respect of an illness or injury

18

Alternative Treatment Cover

19

Medical Treatment Abroad (Applicable for Premiere Plan)

20

Wellness Care

21

Cumulative Bonus

Enjoy our value added services with Future Generali Health Privileges.

Disclaimer For complete details of Policy coverage, terms, conditions and exclusions, please refer the policy wordings. Click here to view Policy Wordings.